RESUMO
The Saudi National Diabetes Registry focuses mainly on adult patients. In 2020, the National Guard Health Authority (NGHA) launched the Saudi Pediatric and Youth Diabetes Registry (SPYDR), for children and adolescents with diabetes. This report is about the first data and the challenges we faced during SPYDR initiation. Patients were identified from the electronic medical records of the Saudi NGHA hospitals using the International Classification of Disease (ICD-10). A trained coordinator verified the diagnosis and entered patients' details into the registry and a random sample was validated by experienced endocrinologists. The data were analyzed according to patients' demography, diabetes subtypes, duration, control, and complications. The challenges faced by the team were identified and addressed. At the time of manuscript submission, 2,344 individuals were enrolled. Their mean age at diagnosis was 9.08 (±4.27) years and 1,136 (48.46%) were females. Of these, 91.3% have type 1 (T1D), and 6.4% have type 2 diabetes (T2D). The mean HbA1c was 10.45% (±2.36) and duration of diabetes was 5.31 (±3.05) years. The main challenges included the COVID-19 pandemic, data validation, and centers' participation. However, within 12 months of initiation enrolled subjects matched the expected number. Despite the challenges, the first step of SPYDR was achieved. The initial data confirmed that T1D is the most common form of childhood diabetes, and the frequency of T2D is comparable to regional and international data. SPYDR provides the infrastructure for data sharing and collaborative research with the enrollment of patients from other Saudi healthcare institutes.
RESUMO
This study aimed to assess parents' perceptions of the quality of life (QoL) of their children with type 1 diabetes (T1D) during Ramadan fasting (RF). In this cross-sectional study, an Arabic-translated version of the standard diabetes-specific QoL questionnaire (PedsQL™ version 3.0) was used to compare perceptions of QoL during Ramadan month (Rm) versus non-Rm (NRm) of parents of children/adolescents with T1D from two tertiary hospitals in Riyadh. We used regression analysis to compare proxies (parents' reports) of their perceptions on their children/adolescents' QoL during Rm compared to NRm. A sample of 61 proxies (parents') of two age groups T1D offspring: 8-12 years (41%) and 13-18 years (59%) who reported their perceptions of their children/adolescents QoL during Rm were matched by children/adolescents' age and gender of 61 proxies in NRm. QoL scores of all domains were significantly lower in Rm compared to NRm; p < 0.0001, however, worries domain showed no statistical differences p = 0.052 in a regression analysis. The total aggregate median (IQR) in Rm was 850 (612-1,062) compared to 1,750 (1,475-2,062) in NRm, p < 0.001. The highest differences in NRm and Rm median scores were observed in communications (OR = 3.64; 95% CI 2.7-5.57) and treatment adherence (OR = 3.09; 95% CI 2.48-3.84) domains especially in the age of 13-18 years. Parents of adolescent boys, who are usually risk-takers and more exposed to outdoor activities, perceived lower QoL for them. Parents of adolescents with T1D perceived a lower QoL for their children during RF, especially in the treatment adherence and communication domains.
RESUMO
OBJECTIVE: Congenital hypothyroidism (CH) is a common cause of preventable severe neurocognitive impairment in children. Previously conducted studies describing the natural history of CH in Saudi Arabia were either of shorter duration or a limited number of patients. In this study, we aim to assess our experience in the clinical course and therapeutic outcome of CH in two large tertiary centers in Saudi Arabia. METHODS: This is a retrospective chart review of patients <18 years of age diagnosed with CH at King Abdulaziz Medical City in Jeddah and Riyadh, Saudi Arabia, between 2000 and 2018. Data were collected from the patients' medical records, including epidemiological, clinical, laboratory, and radiological features as well as a long-term outcome of CH. Statistical analysis was carried out using the JMP statistical software. This study was approved by the Institutional Review Board (IRB) at King Abdullah International Medical Research Center (KAIMRC). RESULTS: Out of the 71 cases, 53.5% were female, and 80.3% of these cases were diagnosed in the 1st week of life. The estimated incidence of CH is 1:2470 in the two study centers. Ectopic thyroid (43%, n = 25/58), dyshormonogenesis (34.5%, n = 20/58), and thyroid agenesis and hypoplasia (22.4%, n = 13/58). Learning difficulty was significantly associated with delayed treatment onset (P = 0.044) and lower compliance with treatment (P = 0.001). CONCLUSION: In our study, the incidence of dyshormonogenesis in CH is higher than international rates (34.5% vs. 20%), possibly because of consanguinity. Effective neonatal screening program facilitates early diagnosis that leads to prompt management of CH and avoidance of long-term outcome of neurocognitive impairment.
RESUMO
BACKGROUND: Diabetes mellitus is a chronic illness that is a worldwide issue. HbA1c has been used to monitor glycemic control in patients with diabetes for many years. Although HbA1c measurement is needed for calculating estimated average blood glucose (eAG), it is now recommended that eAG is used instead of HbA1c for expression of blood glucose control and communication with patients and health care providers. This study, investigated fasting blood glucose (FBS) as an indicator of overall chronic blood sugar control by assessing the correlation between FBS with eAG derived from HbA1c. METHODS: The blood samples for HbA1c assay were collected in EDTA tubes and were analyzed by an HPLC analyzer (G8 Tosoh, Japan). Blood samples for FBS were collected in serum separator tubes, transported, and centrifuged for 15 minutes at 3,000 g. FBS levels were determined in serum samples with the enzymatic hexokinase method by a clinical chemistry analyzer (Architect 8000, Abbott, USA). RESULTS: Statistical analysis was performed on 1,740 patients with type 2 diabetes mellitus with HbA1c levels above 6.5 mmol/L. The difference between FBS (9.3 ± 3.7 mmol/L) and eAG (11.14 ± 2.7 mmol/L) was statistically signif-icant (p < 0.0001). The correlation coefficient between FBS and eAG was r = 0.65 (95% CI; 0.62 - 0.69), with a p-value < 0.0001. While the correlation coefficient between FBS and eAG at HbA1c < 6.5% was r = 0.251 (95% CI, 0.16 - 0.34), with a significant p-value of < 0.00001. The combined data, standard deviation (SD), median, and interquartile range of eAG and FBS for all of the diabetic groups (n = 2,315), were 10.1 ± 3.00 mmol/L, 9.5 mmol/L, and 7.75 - 12.03 mmol/L for eAG, respectively. Similarly, these values were 8.5 ± 3.6 mmol/L, 7.5 mmol/L, and 6.0 - 10.00 mmol/L for FBS, respectively. CONCLUSIONS: We concluded that there is a moderate and significant positive correlation between fasting blood sugar and the estimated average blood glucose derived from HbA1c. Although FBS might be helpful for daily monitoring of diabetes. Further studies must be conducted to provide solid results to support that FBS and its derived variable eAG can replace HbA1c as an indicator of long-term overall control of T2DM patients.
